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Melphalan and Dexamethasone (Mel-Dex) and AL amyloidosis Infoguide

This Infoguide provides information about melphalan and dexamethasone (Mel-Dex), one of the combination treatments used in AL amyloidosis.

This Infoguide provides information about melphalan and dexamethasone (Mel-Dex), one of the combination treatments used in AL amyloidosis. It aims to:

  • Provide you with more information about Mel-Dex
  • Answer some of the more common questions about Mel-Dex
  • Help you make informed decisions about the treatment options available to you

Mel-Dex is an oral (tablet form) combination treatment for AL amyloidosis. It is often referred to as ‘chemotherapy’ or ‘chemo’, but it is actually a combination of two different drugs:

  • Melphalan (a chemotherapy drug)
  • Dexamethasone(a steroid)

These two drugs have different but synergistic and complementary mechanisms of action. This means that they work
in different ways, but when used together, they are more effective at killing abnormal plasma cells in the bone marrow than when they are given alone.

Melphalan, also known as Alkeran®, is a chemotherapy drug. Melphalan is usually given orally (tablet form) when used in the Mel-Dex combination. However, in other circumstances it may be given intravenously (into a vein).

In the Mel-Dex combination, melphalan is given on days 1 to 4 of a 28-day treatment cycle.

As with all drugs, melphalan has a number of possible side effects. These vary considerably from patient to patient: what might be mild in one person can be more serious in another. These side effects are described in the infuosheet.

Dexamethasone is a synthetic steroid which acts like a naturally occurring hormone produced in the body. It is not
the same as the anabolic steroids sometimes used illegally by sportsmen.

Dexamethasone is usually given orally when used in the Mel-Dex combination but, in other circumstances, it may be
given intravenously. In the Mel-Dex combination, dexamethasone is given on days 1 to 4 and days 15 – 18 in a 28-day
treatment cycle.

Dexamethasone has a number of possible side effects. Some of these vary according to the dose, with increasing side effects associated with higher doses.